using the skoool™ he platform: elearning · pdf file system, plan for evaluation...

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    UNFPA (Geeta Lal)

    Jhpiego (Peter Johnson, Leah Hart, Sarah Searle, Alison Trump)

    Intel (Mathew Taylor, Narayan Sundararajan)

  • eLearning Implementation Guide iii


    Foreword iv

    Introduction 1

    Why eLearning? 1

    Purpose of This Guide 2

    Accessing the skoool HE Platform 4

    Current Modules 4

    Pre-Service Training 6

    Stakeholder Buy-In and Support 9

    Implementing the Program 18

    Planning 18

    Training 18

    Implementation Testing 18

    Dissemination 18

    Ongoing Support 18

    Appendix A: Material and Human Resource Requirements for eLearning

    Program Initiation 20

    Appendix B: Sample Job Description for Information and Communication

    Technology (ICT) Advisor 24

    Appendix C: Sample Job Description for eLearning Systems Integrator 26

    Appendix D: Sample Job Description for eLearning Content Creator 27

  • iv eLearning Implementation Guide


    The eLearning Modules for Midwives and Frontline Health Care Workers resulted from a

    partnership between UNFPA, Intel, Jhpiego, and the World Health Organization (WHO). The

    modules aim to build frontline health care workers’ expertise in essential lifesaving skills to

    prevent maternal/newborn deaths. In addition, because the modules are electronic, learning

    institutions can collect learner performance data, which can be used to improve performance

    management and quality control.

    Designed to be easy to use, with evidence-based training methods incorporated, the modules

    present case studies that guide the user through real-life (normal and emergency) situations

    that occur during pregnancy and childbirth. For maximum impact, the modules should be

    disseminated as part of a comprehensive eLearning program or blended into the existing

    curriculum to enhance in particular, the lifesaving skills. This implementation guide provides

    high-level guidance on designing and implementing an eLearning program using the


    The four partners involved in producing the modules each had a different role. The modules

    are based largely on WHO’s Integrated Management of Pregnancy & Childbirth (IMPAC)

    manuals, which focus on the signal functions necessary for health care workers to address the

    top causes of maternal mortality. Jhpiego, an international nongovernmental organization

    with expertise in capacity-building and health systems strengthening, provided innovative

    training solutions and multimedia content for the modules. UNFPA provided overall project

    management, coordination, and implementation support as well as technical expertise in

    sexual and reproductive health and midwifery and operationalization at the country level.

    Finally, Intel contributed to the partnership by engineering the no-charge skoool™

    Healthcare Education platform that allows eLearning modules to be accessed on Windows-

    based platforms, with or without internet connectivity, along with interpretation of learners’

    usage characteristics.

    The module content was reviewed by UNFPA, Jhpiego, and WHO technical experts. In

    addition, a technical advisory group with members from the International Federation of

    Gynecology and Obstetrics (FIGO), the International Confederation of Midwives (ICM), and

    the International Council of Nurses (ICN) reviewed the technical content of the eLearning


  • eLearning Implementation Guide 1

    Blended learning is a “combination of off- or online learning and face-to-face instruction.”


    eLearning is “instruction delivered on a digital device such as a computer or mobile device that is intended to support learning.”




    Electronic learning, or eLearning, can be as effective as or

    even more effective than live instruction. It can also be more

    efficient if effective techniques are used—especially for the

    development of knowledge and critical thinking and

    decision-making skills. 1,2

    The current availability of low-

    cost mobile devices such as netbooks and tablets provides

    the opportunity to extend eLearning to the frontline and to

    support health workers in improving their decision-making

    and performance. eLearning is easily adaptable to local

    contexts and languages.

    It is important to keep in mind that eLearning is one component of a blended learning

    strategy that supports the development of target competencies and must be aimed at the right

    constellation of health workers. Other components of the strategy may include demonstration,

    practice, mentorship, and simulation. This guide focuses on implementation of eLearning and

    the advantages that eLearning offers to a comprehensive education and training strategy.

    Table 1 summarizes some of these advantages.

    Table 1. Traditional training vs. eLearning

    Common Training Methods

    Challenges with Common Training Methods

    Strategic Advantages of Multimedia eLearning

    In-Service Training

    Off-site/ workshop training

    Removes workers from their job site, sacrificing valuable human resources and pressuring trainers to reduce training time, which can result in sub-optimal changes in performance.

    eLearning lessons can be accessed readily by all health workers at a time when they are needed most (urgently), based on identified performance gaps in the workplace.

    Knowledge transfer is low and continues to deteriorate over time; demonstrable change in practice is less than ideal.

    Workers can receive continuing updates, consider recent evidence, and maintain skills through ongoing exposure to training content.

    Onsite training

    Limited reach: Training does not reach the majority of health workers attending births; single cadre training does not promote teamwork.

    eLearning has the capacity to reach higher numbers and a greater range of health workers.

    Cost Training is expensive, with little return on investment.

    eLearning provides a basis for low-cost follow-up after in-person training to help reinforce new skills, and allows practitioners to take responsibility for facilitating ongoing learning.

    1 Bluestone J et al. Effective In-Service Training Techniques, Frequency, Setting and Media: Evidence from an

    Integrative Review of the Literature. Baltimore: Jhpiego, 2012.

    2 Means B, Toyama Y, Murphy R, Bakia M, Jones K. Evaluation of Evidence-Based Practices in Online Learning:

    A Meta-Analysis and Review of Online Learning Studies. U.S. Department of Education, 2010. 3 Clark RC and Mayer RE. E-Learning and the Science of Instruction: Proven Guidelines for Consumers and

    Designers of Multimedia Learning. 3rd ed. San Francisco: Pfeiffer, 2011.

  • 2 eLearning Implementation Guide

    Common Training Methods

    Challenges with Common Training Methods

    Strategic Advantages of Multi-Media eLearning

    Pre-Service Education


    Enrollment in PSE programs

    Limited numbers of health care workers trained

    Midwives trained remotely are more likely to serve hard-to-reach populations. Training can be extended to where it is most needed, encouraging retention and representative distribution of the health care workforce.

    Curriculum Keeping content updated Students can be trained on the most up-to- date evidence, improve understanding of critical concepts.

    Clinical practice

    Clinical placements limited and may include limited exposure to critical clinical situations

    Students can view video or animated demonstrations and develop clinical decision-making skills in a safe and stress- free learning environment. Clinical conditions that are rare but highly critical can be simulated through an eLearning environment, improving necessary decision-making and clinical skill mastery.

    Simulation Limited opportunities for practice through simulation

    eLearning promotes virtual simulation, which increases opportunities for knowledge transfer and clinical decision- making practice, thus maintaining or increasing competency and confidence through regular exposure that is traceable through the skoool™ HE system.

    Quality of training materials

    Validated materials or training approach not always available.

    Prototype eLearning modules use internationally validated materials involving multiple global experts and stakeholder groups (ICN, ICM, FIGO, WHO, UNFPA, Jhpiego).


    The guide was created to enable ministries and stakeholders, including educational

    institutions, administrators, professional associations, and councils that are interested in

    supporting or expanding health care worker education via eLearning, to mainstream training

    on key lifesaving functions. eLearning does not replace skills training or facility-based

    learning, which are face-to-face experiences that learners need to obtain practice and receive